Arizona Form 120a - Arizona Corporation Income Tax Return (Short Form) - 2011 Page 2

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Arizona Corporation Income Tax Return (Short Form)

ARIZONA FORM

2011

120A

M M D D Y Y Y Y

For the

calendar year 2011 or

ﬁ scal year beginning

and ending

Business telephone number

Name

Employer identiﬁ cation number (EIN)

Please

(

)

Type

Number and street or PO Box

Business activity code number

AZ transaction privilege tax number

(from federal Form 1120)

City, or town, state, and ZIP code

CHECK BOX IF: Return ﬁ led under extension.

Check box if:

This is a first return

Name change

Address change

Is FEDERAL return filed on a consolidated basis?

Yes

REVENUE USE ONLY. DO NOT MARK IN THIS AREA.

If yes, list EIN of common parent from consolidated return:

NOTE: Use Form 120 to file an ARIZONA consolidated return. Taxpayers cannot use

Form 120A to file an Arizona consolidated return.

Is this the corporation’s final ARIZONA return?

Yes

If yes, check one:

Dissolved

Withdrawn

Merged/Reorganized

List EIN of the successor corporation, if any:

Arizona Taxable Income Computation

1 Taxable income - per attached federal return ...................................................................................................................

2 Additions to taxable income - from page 2, Schedule A, line A11 ....................................................................................

3 Total taxable income - add lines 1 and 2 ..........................................................................................................................

4 Subtractions from taxable income - from page 2, Schedule B, line B12...........................................................................

5 Adjusted income - subtract line 4 from line 3 ....................................................................................................................

6 Arizona basis net operating loss carryforward - attach computation schedule .................................................................

7 Arizona taxable income - subtract line 6 from line 5 .........................................................................................................

Arizona Tax Liability Computation

8 Enter tax. Tax is 6.968 percent of line 7 or ﬁ fty dollars ($50), whichever is greater ..................................................

9 Tax from recapture of tax credits - from Form 300, Part II, line 26 ...................................................................................

10 Subtotal - add lines 8 and 9 .............................................................................................................................................. 10

11 Clean Elections Fund Tax Reduction. Check this box to send $5 to the fund and reduce the tax (line 10) by $5.

Enter the amount of the tax reduction............................................................................................................... 11A

12 Nonrefundable tax credits - from Form 300, Part II, line 51 .............................................................................................. 12

13 Credit type - enter form number for each nonrefundable credit claimed

14 Tax liability - subtract the sum of lines 11 and 12 from line 10 .......................................................................................... 14

15 Clean Elections Fund Tax Credit. SEE INSTRUCTIONS BEFORE COMPLETING THIS LINE ...................................... 15

16 Tax liability after Clean Elections Fund tax credit - subtract line 15 from line 14 .............................................................. 16

Tax Payments

17 Refundable tax credits. Check box(es) and enter amount(s) 17

308

342 ........

18 Extension payment made with Form 120EXT or online - see instructions ...........................

19 Estimated tax payments - see instructions ...........................................................................

20 Total payments - see instructions ..................................................................................................................................... 20

Computation of Total Due or Overpayment

21 Balance of tax due - If line 16 is larger than line 20, enter balance of tax due. Skip line 22 ............................................ 21

22 Overpayment of tax - If line 20 is larger than line 16, enter overpayment of tax .............................................................. 22

23 Penalty and interest .......................................................................................................................................................... 23

24 Estimated tax underpayment penalty - If Form 220 is attached, check box.................................................. 24A

25 Donation to Citizens Clean Elections Fund - see instructions .......................................................................................... 25

0 00

26 TOTAL DUE - see instructions ....................................................................................Payment must accompany return

27 OVERPAYMENT - see instructions .................................................................................................................................. 27

28 Amount of line 27 to be applied to 2012 estimated tax .........................................................

29 Amount to be refunded - subtract line 28 from line 27 ...................................................................................................... 29

ADOR 10949 (11) Eff. 8/2/2012